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. 2022 Aug 9;24(1):190.
doi: 10.1186/s13075-022-02883-x.

Treatment of rheumatoid arthritis and its outcomes in an aging society: a single-center cohort study in Japan from 2011 to 2020

Wataru Fukuda  1 , Masatoshi Kadoya  2 , Atsushi Omoto  2 , Takuya Yanagida  2 , Yu Isoda  2 , Atsuhiko Sunaga  3 , Hiroaki Kusuoka  3 , Kentaro Ueno  4 , Satoshi Morita  4 , Masataka Kohno  3 , Yutaka Kawahito  3
Affiliations

Treatment of rheumatoid arthritis and its outcomes in an aging society: a single-center cohort study in Japan from 2011 to 2020

Wataru Fukuda et al. Arthritis Res Ther. .

Abstract

Background: We conducted a single-center cohort study of rheumatoid arthritis (RA) patients from 2011 to 2020 to understand their real world treatment and outcomes, especially changes in physical function and quality of life (QOL) in elderly patients, including those aged ≥ 80 years.

Methods: For RA patients attending our outpatient clinic, we annually recorded tender and swollen joint counts, laboratory findings, therapeutic drugs, and scores from the Japanese Health Assessment Questionnaire and EuroQoL-5 Dimensions questionnaire. We examined changes in treatment and outcomes over time, by age group, in patients enrolled over a 10-year period, from 2011 to 2020.

Results: One thousand eight hundred thirty RA patients were enrolled and data were recorded once a year, and a total of 9299 patient records were evaluated. The average age of patients increased by 3.7 years during the study period; the patients aged rapidly. Intensive pharmacological treatment was more frequent in younger patients. Disease activity, physical function, and QOL showed improvement in all age groups over the study period. Physical function and QOL showed greater changes with aging, compared with disease activity. This may be due to the effects of accumulated RA damage, disability due to aging, and depression.

Conclusions: Intensive pharmacological treatment contributes to not only control of disease activity but also the improvement of physical activity and QOL, even in elderly patients. Relieving age-related physical impairment and depression may improve the QOL of very elderly RA patients.

Keywords: Elderly; Health Assessment Questionnaire (HAQ); Quality of life; Rheumatoid arthritis.

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Conflict of interest statement

WF has received speaker’s fee from Chugai Pharmaceutical Co., Eisai Co., Ltd., Eli Lilly Japan K.K., AbbVie GK, Ono Pharmaceutical Co. Ltd., Astellas Pharma Inc., UCB Japan Co. Ltd., Pfizer Japan Inc., Asahikasei Pharma Co., Daiichi-Sankyo Inc., Mitsubishi Tanabe Pharma Co. (less than $10,000 each). AO received speaker’s fees from AbbVie GK, Chugai, Eizai Co., Ltd., Ono Pharmaceutical Co. Ltd., Daiichi-Sankyo Inc., Astellas Pharma Inc., Mitsubishi-Tanabe Pharma Co., Pfizer Japan Inc., Asahikasei Pharma Co., Novartis, Gilead Science Inc., Janssen Pharmaceutical K.K., GlaxoSmithKline K.K., and Eli Lilly Japan K.K. (less than $10,000 each). SM has received speaker’s fee from Bristol Myers Squibb Co. (less than $10,000). MK (Masataka Kohno) has received speaker’s fee from AbbVie GK, Astellas Pharma Inc., Bristol Myers Squibb Co., Chugai Pharmaceutical Co., Ltd. Daiichi Sankyo Co., Eli Lilly Japan K.K, Janssen Pharmaceutical K.K., Mitsubishi Tanabe Pharma Co., Asahikasei Pharma Co., Pfizer Japan Inc., Sanofi Japan K.K., Nippon Boehringer Ingelheim Co. Ltd., UCB Japan Co. Ltd., Eisai Co. Ltd., GlaxoSmithKline K.K. (less than $10,000 each). YK has received research grants from AbbVie GK, Asahi Kasei Pharma Corp., Astellas Pharma Inc., Ayumi Pharmaceutical Corp., Boehringer Ingelheim Japan, Inc., Bristol Myers Squibb Co., Chugai Pharmaceutical Co. Ltd., Daiichi-Sankyo, Inc., Eisai Co., Ltd., Mitsubishi Tanabe Pharma Co., Pfizer Japan Inc., Takeda Pharmaceutical Co., Ltd., and Teijin Pharma Ltd. YK has received speaker’s fee from AbbVie GK, Ayumi Pharmaceutical Corp., Boehringer Ingelheim Japan, Inc., , Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Eli Lilly Japan K.K., GlaxoSmithKline K.K., Pfizer Japan Inc., Takeda Pharmaceutical Co., Ltd., and Teijin Pharma Ltd. (less than $10,000 each). MK (Masatoshi Kadoya), TY, YI, AS, HK, and KU have no competing interests.

Figures

Fig. 1
Fig. 1
Annual trends and changes in RA treatment outcomes from 2011–2020 for each age group. A Annual change of mean DAS28-CRP values, for all patients and for each age group. B Annual change of mean JHAQ scores, for all patients and for each age group. C Annual change of mean EQ5D values, for all patients and for each age group. Abbreviations: DAS28, 28-joint Disease Activity Score; JHAQ, Japan Health Assessment Questionnaire; EQ5D, EuroQol-5 Dimensions questionnaire
Fig. 2
Fig. 2
Changes of RA treatment outcomes by age groups. A Changes in mean DAS28-CRP values, by age group, for the entire period and for each year. B Changes in mean JHAQ scores, by age group, for the entire period and for each year. C Changes in mean EQ5D values, by age group, for the entire period and for each year. Abbreviations: DAS28, 28-joint Disease Activity Score; JHAQ, Japan Health Assessment Questionnaire; EQ5D, EuroQol-5 Dimensions questionnaire
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